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Advances in Respiratory Medicine is published by MDPI from Volume 90 Issue 4 (2022). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Via Medica.

Adv. Respir. Med., Volume 87, Issue 3 (June 2019) – 12 articles , Pages 135-202

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253 KiB  
Letter
Regression of Renal Cyst in a NSCLC Patient Treated with Crizotinib
by Shinichiro Okauchi, Koji Kawai, Kunihiko Miyazaki, Hideyasu Yamada and Hiroaki Satoh
Adv. Respir. Med. 2019, 87(3), 201-202; https://doi.org/10.5603/ARM.2019.0031 - 28 Jun 2019
Viewed by 348
Abstract
Dear Editor [...] Full article
569 KiB  
Case Report
Cystic Transformation of Cannon Ball Metastases in Response to EGFR TKI
by Satyajeet Sahoo, Prasanta Raghab Mohapatra, Saroj Kumar Das Majumdar and Mantyu Chhatria
Adv. Respir. Med. 2019, 87(3), 199-200; https://doi.org/10.5603/ARM.2019.0032 - 28 Jun 2019
Viewed by 327
Abstract
A 39-year-old never smoker male with a 3-month history of progressive dyspnea was found to have a heterogeneously enhancing right lung mass with multiple [...] Full article
517 KiB  
Case Report
Air outside the Airways: An Unusual Complication of Asthma
by Nitesh Gupta, Mahendran A. J., Shibdas Chakrabarti and Sumita Agrawal
Adv. Respir. Med. 2019, 87(3), 196-198; https://doi.org/10.5603/ARM.2019.0026 - 28 Jun 2019
Cited by 1 | Viewed by 310
Abstract
A 19-year-old male [...] Full article
156 KiB  
Case Report
One-Shot Diagnosis: Ebus-Tbna as a Single Procedure for Thyroid, Pulmonary and Lymph Nodal Lesions
by Niccolò Filippi, Elena Prisciandaro, Juliana Guarize, Stefano Maria Donghi, Giulia Sedda and Lorenzo Spaggiari
Adv. Respir. Med. 2019, 87(3), 194-195; https://doi.org/10.5603/ARM.2019.0027 - 28 Jun 2019
Cited by 3 | Viewed by 296
Abstract
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has proved to be the best approach to mediastinal investigation [...] Full article
2365 KiB  
Case Report
Masking of Obstructive Sleep Apnoea by Drug Induced Central Sleep Apnoea
by Shibdas Chakrabarti, Srikar Darisetty, Nitesh Gupta and Pranav Ish
Adv. Respir. Med. 2019, 87(3), 189-193; https://doi.org/10.5603/ARM.2019.0030 - 28 Jun 2019
Cited by 1 | Viewed by 336
Abstract
Benzodiazepines are widely prescribed hypnotic agents which have multiple proven neurological and respiratory side effects. However, literature is sparse with regards to the incidence and occurrence of new onset central sleep apnoea in individuals being treated with benzodiazepines for insomnia. We present a [...] Read more.
Benzodiazepines are widely prescribed hypnotic agents which have multiple proven neurological and respiratory side effects. However, literature is sparse with regards to the incidence and occurrence of new onset central sleep apnoea in individuals being treated with benzodiazepines for insomnia. We present a Case Report of a patient presenting with new onset central sleep apnoea secondary to long term usage of benzodiazepines, with resultant masking of his pre-existing obstructive sleep apnoea. Full article
189 KiB  
Review
Is Inhaled Heparin a Viable Therapeutic Option in Inhalation Injury?
by Michał Zieliński, Piotr Wróblewski and Jerzy Kozielski
Adv. Respir. Med. 2019, 87(3), 184-188; https://doi.org/10.5603/ARM.2019.0029 - 28 Jun 2019
Cited by 4 | Viewed by 654
Abstract
Inhalation injury is a major cause of morbidity and mortality in patients with burns. Presence of airways injury adds to the need of fluid supplementation, increases risk of pulmonary complications. Due to many mechanisms involved in pathophysiology the treatment is complex. Among them [...] Read more.
Inhalation injury is a major cause of morbidity and mortality in patients with burns. Presence of airways injury adds to the need of fluid supplementation, increases risk of pulmonary complications. Due to many mechanisms involved in pathophysiology the treatment is complex. Among them the formation of fibrin casts inside airways constitutes a prominent element. The material residing in tracheobronchial tree causes ventilation-perfusion mismatch, complicates mechanical ventilation, provides a medium for bacterial growth. Many studies of animal models and single centre human studies investigated inhaled anticoagulation regimens employing heparin in management of inhalation injury. Simultaneously safety, especially in connection with possible bleeding risk, was the subject of research. The results suggest positive impact on treatment results, with low risk of side effects. This paper revise the available clinical data on inhaled heparin use in patients with burns. Full article
418 KiB  
Article
Evaluation of Mediastinal Lymphadenopathy by Diffusion Weighted MRI; Correlation with Histopathological Results
by Hoda Ali Abou Youssef, Mahmoud Abdelrahman Elzorkany, Sabah Ahmed Mohamed Hussein, Takeya Ahmed Taymour and Menna Helmy Mohamed Abdel Gawad
Adv. Respir. Med. 2019, 87(3), 175-183; https://doi.org/10.5603/ARM.2019.0033 - 28 Jun 2019
Cited by 6 | Viewed by 401
Abstract
Introduction: Diffusion weighted imaging (DWI) has shown its potential as a reliable noninvasive technique for tissue characterization. DWI reflects the tissue specific diffusion capacity which can be used for tissue characterization. Hypercellular tissue (e.g., malignant tumors) had restricted diffusion capacity with increased signals [...] Read more.
Introduction: Diffusion weighted imaging (DWI) has shown its potential as a reliable noninvasive technique for tissue characterization. DWI reflects the tissue specific diffusion capacity which can be used for tissue characterization. Hypercellular tissue (e.g., malignant tumors) had restricted diffusion capacity with increased signals on DWI and low ADC values. Non-tumoral tissues show low cellularity, and diffusion capacity is not restricted resulting in signal loss on DWI and high apparent diffusion coefficient (ADC). Differential diagnosis of mediastinal lymphadenopathy is an issue of debate, especially in malignant benign differentiation. Diffusion weighted imaging with magnetic resonance could improve the diagnostic accuracy in differentiation between benign and malignant mediastinal nodes. Objectives: to determine the efficacy of diffusion weighted MRI in evaluation of mediastinal lymphadenopathy with histopathological correlation to differentiate benign from malignant lymph nodes. Material and methods: 30 patients with mediastinal lymphadenopathy underwent diffusion weighted MRI. ADCs of lymph nodes were derived and constructed from b = 0 and b = 1000 s/mm2 values by drawing regions of interests (ROI). Consequently, mediastinal nodes were studied, biopsies and histopathological analysis were done after MRI examination. Results: The best cutoff point of ADC to differentiate benign from malignant lesions was 1.15 mm/s (sensitivity 77%, specificity 92% and AUC 81.4%). Significant negative correlation of ADC by DW MRI and the size of the LNs. The mean ADC values in the lymphoma group was lower than in the sarcoidosis group, and the difference was statistically significant. Conclusions: The study supports that MRI with diffusion weighted images can differentiate benign from malignant mediastinal lymphadenopathy and differentiate lymphoma from sarcoidosis non-invasively. Full article
182 KiB  
Article
Health Status of Patients Who Suffer from COPD, Asthma and Acute Respiratory Diseases in Greece in the Era of Economic Crisis
by Panagiota Koutsimpou, Konstantinos Gourgoulianis, Athina Economou and Vasilios Raftopoulos
Adv. Respir. Med. 2019, 87(3), 167-174; https://doi.org/10.5603/ARM.2019.0028 - 28 Jun 2019
Cited by 2 | Viewed by 459
Abstract
Introduction: In Greece, the last decade, the harsh austerity measures, that were enacted, had a huge impact on patients’ suffering from chronic diseases. The aim of the current study was to assess the financial ability of the patients suffering from an acute or [...] Read more.
Introduction: In Greece, the last decade, the harsh austerity measures, that were enacted, had a huge impact on patients’ suffering from chronic diseases. The aim of the current study was to assess the financial ability of the patients suffering from an acute or chronic respiratory disease hospitalized in an urban pulmonary university clinic in central Greece and to explore the correlation of their health status with their financial ability. Material and methods: An anonymous and self completed questionnaire was administered in the Greek language. It included the SF-36 and the EQ-5D-3L scale that are validated in the Greek language and a new scale (Financial Ability Scale, FAS) that has been developed and validated. Results: Half of the patients (55%) suffered from a chronic respiratory disease (64% COPD and 36% asthma) while 45% from an acute respiratory disease (pneumonia). Those suffering from COPD were mainly males (88.7%), over 65 years old (74.6%), with primary education or some primary (83.1%), covered by public health insurance (95.8%) and living with their families (91.5%). With the exception of anxiety/depression, the more the problems with mobility, self-care, usual activities and pain/discomfort, the worse the financial ability of the participants. Those >65 years old, with fewer years of education, suffering from a chronic disease and those having a better experience from the current hospitalization, had a statistically significant lower VAS. Those aged >65 years old reported a lower financial ability (26.00 ± 9.41 vs. 29.24 ± 10.63) as well as those with a chronic respiratory disease (24.18 ± 7.90 vs. 30.57 ± 11.98). The years lived with the disease correlated statistically and negatively (r = −0.232; p = 0.001) with the total financial ability score. Conclusions: Economic crisis in Greece, affected COPD burden in terms of financial ability, and quality of life. Full article
1393 KiB  
Article
Levels of CD4+ CD25+ T Regulatory Cells in Bronchial Mucosa and Peripheral Blood of Chronic Obstructive Pulmonary Disease Indicate Involvement of Autoimmunity Mechanisms
by Virginija Sileikiene, Aida Laurinaviciene, Daiva Lesciute-Krilaviciene, Laimute Jurgauskiene, Radvile Malickaite and Arvydas Laurinavicius
Adv. Respir. Med. 2019, 87(3), 159-166; https://doi.org/10.5603/ARM.2019.0023 - 28 Jun 2019
Cited by 14 | Viewed by 616
Abstract
Introduction: Many theories have been proposed to explain pathogenesis of COPD; however, remains unclear why the majority of smokers (~80%) do not develop COPD, or only develop a mild disease. To explore if COPD has an autoimmune component, the role of T regulatory [...] Read more.
Introduction: Many theories have been proposed to explain pathogenesis of COPD; however, remains unclear why the majority of smokers (~80%) do not develop COPD, or only develop a mild disease. To explore if COPD has an autoimmune component, the role of T regulatory lymphocytes (Tregs) in the lung tissue of COPD patients is of crucial importance. Material and methods: Bronchial tissue biopsy samples were prospectively collected from 64 patients (39 COPD and 25 controls—15 smokers and 10 non-smokers). The patients with COPD were subdivided into mild/moderate (GOLD stage I−II) and severe/very severe (GOLD stage III−IV) groups. Digital image analysis was performed to estimate densities of CD4+ CD25+ cell infiltrates in double immunohistochemistry slides of the biopsy samples. Blood samples were collected from 42 patients (23 COPD and 19 controls) and tested for CD3+ CD4+ CD25+ bright lymphocytes by flow cytometry. Results: The number of intraepithelial CD4+ CD25+ lymphocytes mm-2 epithelium was significantly lower in the severe/very severe COPD (GOLD III–IV) group as well as in the control non-smokers (NS) group (p < 0,0001). Likewise, the absolute number of Treg (CD3+ CD4+ CD25+ bright) cells in the peripheral blood samples was significantly different between the four groups (p = 0.032). The lowest quantity of Treg cells was detected in the severe/very severe COPD and healthy non-smokers groups. Conclusions: Our findings suggest that severe COPD is associated with lower levels of Tregs in the blood and bronchial mucosa, while higher Tregs levels in the smokers without COPD indicate potential protective effect of Tregs against developing COPD. Full article
691 KiB  
Article
Predictors of Airway Hyperreactivity in House Dust Mite Allergic Patients
by Agnieszka Pampuch, Robert Milewski, Agata Rogowska and Krzysztof Kowal
Adv. Respir. Med. 2019, 87(3), 152-158; https://doi.org/10.5603/ARM.2019.0025 - 28 Jun 2019
Cited by 5 | Viewed by 519
Abstract
Introduction: Airway hyperresponsiveness (AHR) is a cardinal feature of asthma. Asthma is a heterogenous disorder which consists of different phenotypes and endotypes. Mechanisms leading to AHR may differ in different asthma subtypes. Allergy to perennial allergens, including house dust mites (HDM) is a [...] Read more.
Introduction: Airway hyperresponsiveness (AHR) is a cardinal feature of asthma. Asthma is a heterogenous disorder which consists of different phenotypes and endotypes. Mechanisms leading to AHR may differ in different asthma subtypes. Allergy to perennial allergens, including house dust mites (HDM) is a major risk factor for asthma development. The aim of this study was to determine predictors of AHR in a well-characterized population of HDM-allergic patients. Material and methods: In a retrospective analysis 843 patients with HDM-allergic rhinitis with/without asthma were evaluated. The following parameters were included in the analysis: serum concentration of total (t)- and Dermatophagoides pteronyssinus (Dp)-specific IgE, fractional exhaled nitric oxide concentration (FeNO), lung function tests, bronchial challenge with histamine, age sex, and body mass index (BMI). Linear regression analysis was used to determine predictors of AHR. Results: In a simple linear regression analysis baseline lung function results expressed as either forced expiratory volume in 1 s (FEV1) or maximal expiratory flow at 50% of the forced vital capacity (MEF50), FeNO, tIgE, DpIgE, age and BMI affected AHR. A multiple regression analysis demonstrated that in the whole group of HDM-allergic patients the most important, independent predictors of AHR were MEF50, FeNO and DpIgE. Conclusions: Even in a well-characterized asthma phenotype several processes participate in development of AHR. Major, independent predictors of AHR: lung function parameters, FeNO and DpIgE indicate possible targets for therapeutic intervention in a population of HDM-allergic patients. Full article
174 KiB  
Article
The Effectiveness of Relaxation Training in the Quality of Life and Anxiety of Patients with Asthma
by Guitti Pourdowlat, Roghyeh Hejrati and Somayeh Lookzadeh
Adv. Respir. Med. 2019, 87(3), 146-151; https://doi.org/10.5603/ARM.2019.0024 - 28 Jun 2019
Cited by 11 | Viewed by 1638
Abstract
Introduction: With a 5–10% global prevalence, asthma, as a chronic condition which can strongly affect the quality of life of patients and care givers, needs comprehensive approach, including medications and psychological techniques, to get the optimal control. This is why the current study [...] Read more.
Introduction: With a 5–10% global prevalence, asthma, as a chronic condition which can strongly affect the quality of life of patients and care givers, needs comprehensive approach, including medications and psychological techniques, to get the optimal control. This is why the current study aimed to assess the effectiveness of the Papworth method relaxation training among patients with asthma, considering reduced anxiety and improved quality of life. Material and methods: Through a randomized controlled trial, 30 patients with asthma 20–45 years of age referring to a tertiary university hospital in Tehran enrolled two study groups, including disease cases and controls. The Papworth method of relaxation was used and was finally assessed for its effectiveness by two questionnaires, namely STAI for anxiety and SF-36 for the quality of life. Pre-test and post-test were done for both groups. Results: The scores of the anxiety questionnaire (STAI) before and after the intervention were significantly different, and the mean scores obviously reduced after relaxation training among cases from 102.6 to 79.5. The scores of the QOL grew clearly after relaxation training in the case group from 308.07 to 546.6. Conclusions: As an accessory helpful treatment, relaxation training Papworth method sounds to be perfectly able to control stressful conditions in patients with asthma to prevent disease attacks and improve the quality of life. So, psychological teams can be advised to referral centers for asthma in the relevant clinics to help people get training in this regard. Full article
296 KiB  
Article
Dignity Therapy as an Aid to Coping for COPD Patients at Their End-of-Life Stage
by Beata Brożek, Małgorzata Fopka-Kowalczyk, Marta Łabuś-Centek, Iwona Damps-Konstańska, Anna Ratajska, Ewa Jassem, Philip Larkin and Małgorzata Krajnik
Adv. Respir. Med. 2019, 87(3), 135-145; https://doi.org/10.5603/ARM.a2019.0021 - 6 May 2019
Cited by 20 | Viewed by 1144
Abstract
Introduction: Observations indicate that struggling with a burden of an incurable disease such as advanced chronic obstructive pulmonary disease (COPD) may result in the weakening of an individual sense of dignity, and be a source of spiritual suffering. Clinicians providing respiratory care to [...] Read more.
Introduction: Observations indicate that struggling with a burden of an incurable disease such as advanced chronic obstructive pulmonary disease (COPD) may result in the weakening of an individual sense of dignity, and be a source of spiritual suffering. Clinicians providing respiratory care to patients should be open to their spiritual needs, in the belief it may improve coping with the end-of-life COPD. The study aimed to assess overall feasibility and potential benefits of Dignity Therapy (DT) in patients with advanced COPD. Material and methods: Patients with severe COPD, in whom a DT intervention was implemented according to the protocol established by Chochinov et al. were included into the study. An self-designed questionnaire was applied to assess the patients’ satisfaction after intervention. Subsequently, the patients’ statements were allocated to specific problem categories, corresponding to the spiritual suffering concerns, as structured by Groves and Klauser. Results: DT was completed in 10 patients, with no unexpected side effects. Satisfaction Questionnaire showed a positive effect of DT on the patient’ well-being (3.9 on a 5-point Likert scale). The analyses of the patients’ original statements enabled an effective identification of the spiritual suffering and spiritual resources and faced by COPD patients. Conclusions: DT is an intervention well received by COPD patients, which may help them in recognising and fulfilling their spiritual needs in the last phase of their life. Information acquired on the patients’ resources and spiritual challenges may help clinicians improve their care, especially with regard to supporting their patients at the end-of-life stage. Full article
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